Mar 02, 2023
Implementing flexible tools, expert support and integrated solutions for an improved experience
UnitedHealthcare ensures the right drug, at the right price, in the right setting and with the right support — at every step of the employee’s personal health care journey.
UnitedHealthcare is introducing and improving programs that help make it quicker, easier and less expensive for members to get the prescription medications they need — by offering the right drug, at the right price, in the right setting and with the right support.
Right drug
UnitedHealthcare is introducing more supplies and medications into auto-decisioning prior authorization (PA) programs to combat requirements that can slow access to prescribed medications. The Diagnosis to Script program provides real-time coverage and diagnosis information, and now includes diabetic supplies and medications. Nearly 25% of PA requests use automated or auto-decisioning, minimizing disruption and streamlining the process.1
Right price
UnitedHealthcare is taking an important step in its continued efforts to make prescription drugs more affordable by eliminating out-of-pocket costs for drugs that are critical to maintaining the health of our members.
The Vital Medication Program offers the preferred drugs listed below at no out-of-pocket cost to members:
- insulin – Rapid, short and long-acting
- epinephrine – Allergic reactions
- glucagon – Hypoglycemia (low blood sugar)
- naloxone – Opioid overuse
- albuterol – Asthma
This will become a standard offering available to UnitedHealthcare fully insured clients with Optum Rx (carve-in) new business plans and for existing plans upon renewal date, as early as Jan.1, 2023, subject to any required regulatory approval. Self-funded clients can opt-in to this program by reaching out to their UnitedHealthcare representative. This change will be effective for all Jan.1, 2023 – March 1, 2023, groups upon renewal. This change will be effective for all remaining groups on March 15, 2023.
Right setting
Optum® Home Delivery makes it easy to get and afford maintenance medications, which helps drives adherence and reduces the total cost of care for a better member experience overall. With this program, medications arrive at the member’s door quicker than ever — only taking about 2 days from the time the order is processed to the time it’s delivered.2
Right support
Proactive Savings Alerts sends emails to members when they have a chance to save and includes simple steps to follow so they can act right away. These alerts help members save valuable time and frustration and resulted in $77 thousand in savings in June 2022.3
1 UnitedHealthcare internal data, 2022.
2 Optum Rx internal data, 2021.
3 UnitedHealthcare internal data, 2022.
The Vital Medication Program is a standard offering for Fully Insured business beginning Jan. 1, 2023, pending state regulatory approvals.
